Thursday, August 13, 2009

The diagnostic value of coronal dark-gray discoloration in primary teeth follwing traumatic injuries

Resident: Roberts
8/14/09

Article: The diagnostic value of coronal dark-gray discoloration in primary teeth following traumatic injuries
Author: Holan, Gideon
Journal: Pediatric Dentistry
Volume# 18:3 pages: 224-227
Year: 1996
Type of article: retrospective study
Major topic: evaluation of primary teeth following traumatic injury
Key pts: This article attempted to examine the condition of the pulp of primary incisors with dark gray discoloration following traumatic injury. Previous research suggested controversial opinions concerning the matter. Some authors of research suggested that a gray or bluish color indicated pulpal degeneration and suggested that upto 82 percent of gray discolored traumatized teeth develop periapical pathology within 1 month of the trauma. Other authors suggested that dentist not predetermine the fate of primary teeth and that the dark discoloration was in part due to the hemorrhaging of the dentinal tubules followed by hemoglobin breakdown with no possibility of final absorption of the hemosiderin deposits or disappearance of the stain. The only thing that seemed to be agreed upon among the various authors of the published research was that a tooth with a pink or yellow hue did not reflect devitalization of the pulp. For this authors assessment, 48 gray, caries-free, traumatized primary incisors were examined clinically and radio graphically and were found to be free from any signs of pulpal necrosis, for the exception of the discolored crown. This article concluded like previous authors had reported that upto 82 percent of injured primary incisors with gray discoloration developed periapical pathology within 1 month of the trauma, indicating a development towards pulpal necrosis. These teeth even when found to be necrotic often times showed no signs of sensitivity to percussing, or no sign of increased mobility. Nearly half of the teeth showed signs of discoloration within the first 2 weeks following trauma.

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